Correlation of Skeletal and Dental Midlines in Patients with Bimaxillary Protrusion, The Concept of Medical Physics behind Setting Optimised Treatment Goals: A Digital Radiographic Study.

BACKGROUND: An aesthetic smile needs a balanced dental midline and symmetrical dentition. It is in this context that a discrepancy in the facial and dental midlines is considered to be one of the most common problems for orthodontists to correct. AIM: To compare the topographical location of the skeletal (maxillary and mandibular) midlines in comparison with the dental midline in patients with bimaxillary protrusion using digital orthopantomograms. PATIENTS AND METHODS: 150 orthodontic patients aged 11-32 years with Angle's class I molar relation and class I skeletal base with bimaxillary protrusion were included. These participants were examined for their skeletal and dental midlines using digital orthopantomograms and the results obtained were subjected to statistical analysis. RESULTS: Only 34 (22.67%) and 31 (20.67%) subjects revealed their skeletal (maxillary) midline and skeletal (mandibular) midline coinciding with the dental midline respectively. Again, only 60 (40.00%) subjects revealed their skeletal (maxillary) midline coinciding with the skeletal (mandibular) midline, while 30 (20.00%) subjects revealed deviation towards right and 60 (40.00%) subjects revealed deviation towards left when their skeletal (maxillary) midline was compared with the skeletal (mandibular) midline making midline shift towards left a more common phenomenon among the subjects included in the present study. CONCLUSION: The results obtained in the present study may play a significant role during orthodontic treatment planning and in correlating pre-to-post-treatment results following orthodontic corrections.